ASCO Emphasizes Role of Cognitive Services, Quality Improvement in Senate SGR Comments

Posted June 10, 2013

The Senate Finance Committee recently called on ASCO and other medical specialty societies to provide specific feedback on Committee questions regarding the repeal and reform of the sustainable growth rate formula. In its response, the Society underscored its principles of Medicare payment reform, including a period of stability, quality improvement and the testing of different payment models.

In addition, ASCO offered new recommendations to the Committee, specifically focused on the recognition of cognitive work by oncologists, improvement of health information technology systems, and enhancement of quality reporting and improvement.

ASCO believes the physician fee schedule does not adequately recognize cognitive services and care coordination by oncologists. In order for these services to be adequately reimbursement, ASCO recommends implementing care coordination and end-of-life care planning codes to appropriately recognize the significant amount of time that goes into coordinating care for cancer patients.

To help reduce unnecessary utilization to improve health and reduce Medicare spending growth, ASCO recommends improving the infrastructure of electronic health records (EHRs). The ability for disparate EHR systems to communicate is critical to reducing unnecessary care and to better track patient outcomes. In some cases, poor clinical outcomes may be the direct result of inadequate communication among the different EHR systems used by providers, institutions, laboratories, imaging facilities and patients.

In addition, ASCO believes a robust quality measurement and improvement system should serve as the underpinning to any payment model. The recently enacted provision to qualify clinical registries for federal quality reporting is an important step toward engaging the physician community in meaningful quality reporting. Broad participation in such systems drives behavior toward accepted standards, reduces variation in care, and avoids the cost of unnecessary, duplicative or inappropriate services.

To encourage even wider uptake by the oncology community, ASCO recommends implementing an incentive of 5 percent for physician participation. Practices that participate in qualifying clinical registries could also be considered for expedited approvals, or exemption from preauthorization or other administrative requirements to gain approval for treatment or services.

ASCO’s full comments to the Senate Finance Committee are available here